Frailty is a significant predictor of operative complications, institutionalization, and death among elderly surgical patients, highlighting its role in preoperative risk stratification.
Does frailty assessment improve preoperative risk stratification in elderly surgical patients?
Frailty assessment provides an evidence-based framework to guide perioperative management and risk stratification in older surgical patients.
PURPOSE OF REVIEW: Frailty, a state of decreased homeostatic reserve, is characterized by dysregulation across multiple physiologic and molecular pathways. It is particularly relevant to the perioperative period, during which patients are subject to high levels of stress and inflammation. This review aims to familiarize the anesthesiologist with the most current concepts regarding frailty and its emerging role in preoperative assessment and risk stratification. RECENT FINDINGS: Current literature has established frailty as a significant predictor of operative complications, institutionalization, and death among elderly surgical patients. A variety of scoring systems have been proposed to preoperatively identify and assess frail patients, though they differ in their clinical utility and prognostic ability. Additionally, evidence suggests an evolving potential for preoperative intervention and modification of the frailty syndrome. SUMMARY: The elderly are medically complex and heterogeneous with respect to operative risk. Recent advances in the concept of frailty provide an evidence-based framework to guide the anesthesiologist in the perioperative management, evaluation, and risk stratification of older surgical patients.
Amrock et al. (2014) conducted a review in Frailty in elderly surgical patients. Frailty was evaluated. Frailty is a significant predictor of operative complications, institutionalization, and death among elderly surgical patients, highlighting its role in preoperative risk stratification.